New York City ambulances are taking longer to respond to emergencies this year, according to the Mayor’s Management Report, an annual evaluation that shows how well city agencies are performing.

Emergency Medical Services take 11 minutes and 21 seconds to arrive on the scene, a 29-second increase compared to last year and 1 minute and 4 seconds longer than in 2023. 

In Midtown— where an estimated 490,000 cars traverse the district and around 300,000 pedestrians crowd Times Square daily — ambulances routinely battle clogged streets and mounting call volumes.

Walter Adler, a paramedic with more than 20 years of experience, said the official response times don’t account for the added time it takes to access buildings and climb up stairs. “You’re really talking about 14 to 15 minutes before you can get an ambulance in the city,” he said. 

This is not a new problem. According to the mayor’s report, ambulance response time has been increasing every year since 2021, a concerning trend for the world’s busiest emergency medical service. For patients suffering from critical situations, like strokes or heart attacks, the increase in response time can have dire consequences. The American Heart Association warns that irreversible brain damage can begin within four to six minutes without oxygen, and that survival chances drop sharply if CPR isn’t started within eight to ten minutes.

But Midtown’s traffic and crowded streets alone aren’t what’s slowing ambulances. Behind these rising response times lies a deeper problem — chronic understaffing. 

With not enough EMTs and paramedics left on staff, New York’s ambulances are struggling to keep up with the rising demand. On October 10, the NYC Fleet Daily Service Report, a city-issued update that tracks the operational status of municipal vehicles, revealed that out of the 647 ambulances in the FDNY EMS fleet only 378 were on the road, even though 485 were supposed to be in service. 

Meanwhile, the demand for emergency care has never been higher. In 2024, New York City logged a record 1.63 million medical emergencies, the busiest year in EMS history. This year is expected to break that record, likely surpassing 1.7 million emergencies, leaving FDNY EMS with just over 4,500 personnel to handle an ever-growing volume of emergencies, according to the #StandWithEMS Booklet, a union publication.  

“We’re working with tape and glue here,” said Jahrodney Williams, a Lenox Hill paramedic with six years of experience.

According to Oren Barzilay, president of FDNY EMS Local 2507, a labor union for EMTs, paramedics and fire inspectors, low pay lies at the heart of the staffing crisis.

“When members can make more money working in a job with less of a mental and physical toll, it is hard to justify being paid poverty wages as an emergency medical first responder,” said Barzilay in a recent press release. The union introduced the #StandWithEMS campaign earlier this month.

Starting salaries for emergency medical technicians hover around $39,386 a year — far below New York City’s average cost of living of $64.026 a year, forcing some paramedics to rely on food stamps and affordable housing programs.

Consequently, around 70% of New York’s paramedics and EMTs leave the profession within five years, resulting in new recruits responding to more emergencies instead of experienced employees.

“You roll the dice when you call 911,” Adler said. “You could get somebody who’s one foot out the door and still cares enough to be professional, or you could get whoever they managed to get into the seat that day.”

In response to the mounting crisis, the FDNY has launched its “Save Lives. Change Lives” recruitment campaign, aiming to attract new EMS employees through career fairs and public outreach. Meanwhile, state legislators have introduced several bills aimed at stabilizing the city’s collapsing EMS workforce, including mandating minimum staffing standards in large cities and requiring comprehensive EMS plans for local governments. 

But from the union’s position, equitable pay is the only solution to staffing shortages. 

Williams shares a similar view. “It would do the city a real disservice if you dismiss EMS as if they’re an afterthought,” he said. “If you care about having a good, healthy city, invest in your EMS department – heavily.”

Adler argues, in addition to better wages, more structural changes within emergency medical services are needed.

“Hands down, the best solution would be to have a Department of EMS separate from the fire department that consolidates all the 911 resources under one agency,” Adler said. “Nobody in the developed world has ever said it’s a good idea for critical emergency infrastructure to be managed in this strange hybrid way. It makes no sense for either bargaining or for the provision of services.”